|
Diaper Rash
A diaper rash is when the skin under the diaper becomes red and irritated. Medically, it is known as diaper dermatitis.
Diaper rash will affect almost every baby at least once. While there are things you can do to decrease the chances of this happening, your baby is likely to get it anyway. Baby's skin is sensitive. Add to that a moist environment, friction from the diaper rubbing back and forth, and skin-irritating urine and stools; this is the perfect environment for diaper rash.
If your baby gets a little diaper rash, know that it is not your fault. It happens. The trick is catching it early and making it go away as fast as possible.
By far, the most common cause of diaper rash is irritation of the skin from stool or urine. This is known as an irritant diaper rash. Irritant diaper rashes can become more severe if they are infected with yeast or bacteria. This is more likely to happen if the rash is left untreated for more than a couple of days.
Diaper rashes can also be caused by a number of different skin conditions that are unrelated to diaper use and/or irritants. They also can become infected with yeast or bacteria.
What Does a Diaper Rash Look Like?
Your basic run-of-the-mill diaper rash is a flat, red rash within the diaper area. The buttock, upper thighs, lower abdomen (stomach), and genitals are the most common areas affected. It is normally not found within the folds of skin between the body and thighs or body and genitals.
Unlike irritant diaper rash, diaper rashes infected with yeast will often be found within the skin folds.
What a diaper rash looks like varies, based on how severe it is and what is causing it. In more severe cases, the skin can be painful and the rash raised, thickened, peeling, weeping, and/or bleeding. There may also be bumps, blisters, pimples, and/or open sores within the red area or on the outside of the main rash.
Diaper rashes can affect anyone who wears a diaper, although they are most common in infants and toddlers between 9 and 12 months of age.
Most diaper rashes can be treated at home without the need to see your healthcare provider. Successful treatment focuses on minimizing moisture, friction, and irritation from stool and urine to the affected area. This means more frequent diaper changes, diaper-free periods, and being gentle (see Diaper Rash Treatment for specific suggestions).
A cream or ointment is also needed. Many different choices are available without a prescription. These products work as a barrier, either through the cream or ointment itself (such as with petroleum jelly or lanolin) or within the active ingredients (such as zinc oxide). Some brands include Desitin®, Triple Paste®, A & D Ointment ®, Balmex®, Aquaphor®, and Vaseline ®.
More severe diaper rashes or those infected with yeast or bacteria may not get better with the standard treatment. These types of rashes may require a prescription cream or ointment from your healthcare provider.
Things You Can Do to Prevent Diaper Rash
While there is no guarantee that diaper rash can be prevented, there are things you can do to help decrease the chances. Some tips include:
- Change your baby's diaper as soon as it becomes wet or dirty. The less your baby is exposed to skin irritants like urine and/or stool, the better.
- Clean well -- make sure that all the stool is removed from your baby's bottom.
- Allow your baby's skin to dry completely before putting on another diaper.
- Avoid baby wipes that are scented or contain alcohol and/or chlorine.
- Apply a preventative cream or ointment to create a barrier between your baby's bottom and moisture. There are several great products out there, most of which are lanolin- or petroleum jelly-based. They all work to lock out the bad moisture and protect sensitive skin.
- Avoid using plastic pants or diapers with plastic lining. These limit any chance for airflow and trap moisture in.
Cloth Versus Disposable: Does It Matter?
Diaper rashes do not necessarily favor a particular type of diaper. Both cloth and disposable diapers have pluses and negatives pertaining directly to the likelihood of an outbreak of diaper rash.
Disposable diapers tend to do a better job at preventing leaks than cloth diapers do. While that is a good thing, disposable diapers hold heat and moisture in so well that it could set up a good environment for a diaper rash.
Babies wearing cloth diapers, on the other hand, may get rashes often if they are not changed quickly enough after the diaper is soiled. This is because cloth is not as good at wicking moisture away from the baby's skin as the materials used in today's disposable diapers.
Regardless of your choice of cloth or disposable diapers, the best thing you can do is change them frequently. This will decrease the chances of a diaper rash happening in the first place. Most rashes can be treated at home without contacting your healthcare provider.
When to Call Your Healthcare Provider
Fortunately, most rashes get better with home treatment and time. Call your child's healthcare provider if the diaper rash does not improve after the basic treatment steps are taken.
You should also call if your child:
- Is less than one month old and the rash looks like tiny water blisters or pimples in a cluster
- Has a fever above 100.4ºF or 38ºC
- Has bloody stool
- Has a change in the pattern of dirty or wet diapers (such as diarrhea, constipation, or increased urination)
- Looks or acts very sick.
Or if the rash:
- Becomes bright red, with red bumps around the diaper area
- Has grown so that it is now visible in the skin folds
- Has spread beyond the immediate diaper area
- Is very raw, bleeds, or develops open sores
- Does not improve after three days of home treatment.
|
|
List of references (click here)
-
Fleischer AB. Diagnosis and Management of Common Dermatoses in Children: Atopic, Seborrheic, and Contact Dermatitis. Clin Pediatr 2008;47:332-346. Hurwitz S. Clinical Pediatric Dermatology. Philadelphia, Pa: WB Saunders Co; 1981:27-30. Singalavanija S, Frieden IJ. Diaper dermatitis. Pediatr Rev 1995; 16:142. Visscher MO, Chatterjee R, Munson KA, et al. Development of diaper rash in the newborn. Pediatr Dermatol 2000; 17:52. Jordan WE, Lawson KD, Berg RW, et al. Diaper dermatitis: frequency and severity among a general infant population. Pediatr Dermatol 1986; 3:198 Kucers A, Bennett NM. The Use of Antibiotics. 3rd ed. Philadelphia, Pa: JB Lippincott Co; 1979:924. Ward DB, Fleischer AB, Feldman SR, Krowchuk DP. Characterization of Diaper Dermatitis in the United States. Arch Pediatr Adolesc Med, 2000;154(9):943-946. Boiko S. Treatment of diaper dermatitis. Dermatol Clin 1999; 17:235. Humphrey S, Bergman JN, Au S. Practical management strategies for diaper dermatitis. Skin Therapy Lett 2006; 11:1.
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD
|
Other Articles in This eMedTV Presentation
|
|